Bull Jeff, Oster Candice, Flight Ingrid, Wilson Carlene, Koczwara Bogda, Watson David I, Bright Tim
College of Medicine and Public Health, Flinders University Discipline of Surgery, Bedford Park, South Australia, Australia.
Flinders Human Behaviour and Health Research Unit, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Eur J Cancer Care (Engl). 2019 Mar;28(2):e12996. doi: 10.1111/ecc.12996. Epub 2019 Jan 23.
Oesophagectomy for cancer is associated with significant morbidity and mortality, and reduced quality of life. Structured rehabilitation potentially offers improved physical and psychological outcomes. We aimed to explore patient, carer and healthcare provider attitudes and preferences towards the role of rehabilitation.
We interviewed 15 patients who had undergone an oesophagectomy, 10 carers and 13 healthcare providers about perceived impacts of treatment; preferred components of a rehabilitation program; barriers/enablers of support provision; and participation in rehabilitation programs. Data were analysed using framework analysis.
The overarching theme was "Getting back to normal." Diagnosis of disease signified a disruption to the normal trajectory of patients' lives and the post-treatment period was characterised as striving to return to normal. Patients and carers focused on rehabilitation needs post-treatment including dietary support, physiotherapy and healthcare provider support. Healthcare providers described rehabilitation as potentially beneficial from the pre-treatment phase and, along with carers, highlighted the importance of psychological support. Barriers included access to services, cost of service provision and appointment burden.
A need for rehabilitation services was identified by healthcare providers from the point of diagnosis, rather than only after surgery. Implications include improved service provision by healthcare institutions for patients undergoing oesophagectomy.
食管癌切除术与显著的发病率和死亡率相关，且会降低生活质量。结构化康复可能会改善身体和心理状况。我们旨在探讨患者、护理人员和医疗服务提供者对康复作用的态度和偏好。
我们采访了15名接受过食管癌切除术的患者、10名护理人员和13名医疗服务提供者，了解治疗的感知影响；康复计划中偏好的组成部分；支持提供的障碍/促进因素；以及参与康复计划的情况。使用框架分析法对数据进行分析。
总体主题是“恢复正常”。疾病诊断意味着患者正常生活轨迹的中断，治疗后的时期被描述为努力恢复正常。患者和护理人员关注治疗后的康复需求，包括饮食支持、物理治疗和医疗服务提供者的支持。医疗服务提供者表示，从治疗前阶段开始康复可能有益，并且与护理人员一起强调了心理支持的重要性。障碍包括服务获取、服务提供成本和预约负担。
医疗服务提供者从诊断时就确定了对康复服务的需求，而不仅仅是在手术后。这意味着医疗机构要为接受食管癌切除术的患者提供更好的服务。
